D-allulose is a sugar substitute that has been shown to reduce weight gain and body fat accumulation. However, the changes in visceral adipose tissue (VAT) and hepatic fat beyond changes in body weight remain unexplored. We performed a 12-week randomized, placebo-controlled, double-blind, parallel group trial that compared the effects of D-allulose on body composition and hepatic steatosis in obesity.


Ninety-nine subjects were randomly assigned to receive placebo, low-dose D-allulose (6 g/day), or high-dose D-allulose (12 g/day) at a 1:1:1 ratio. To assess abdominal and liver fat distribution, dual-energy X-ray absorptiometry (DEXA) and abdominal CT scan were performed at randomization and at week 12.


Although overall changes in lean body mass were not significantly different among the groups (P = 0.088), there was a decrease in VAT at week 12 in the D-allulose treatment groups (-12.25±17.58 cm2 in 12 g D-allulose, p=0.022 and -6.27±11.02 cm2 in 6 g D-allulose, P < 0.001). Consistent with the decreased visceral fat, D-allulose treatment showed increased liver attenuation, liver-to-spleen attenuation difference and liver-to-spleen attenuation ratio, which is indicative of an improvement in hepatic steatosis (P < 0.001).


D-allulose reduced visceral and hepatic fat without weight gain, indicating that D-allulose promotes a healthy fat distribution regardless of body weight change.